Features of respiration biomechanics at mechanical pressure-controlled helium-oxygen ventilation
- Authors: Grachev IN1, Bogomolov BN1, Shchegolev AV1, Makarenko EG1, Ershov EN1
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Affiliations:
- S.M. Kirov Military Medical Academy
- Issue: Vol 100, No 3 (2019)
- Pages: 445-450
- Section: Experimental medicine
- URL: https://journals.rcsi.science/kazanmedj/article/view/13301
- DOI: https://doi.org/10.17816/KMJ2019-445
- ID: 13301
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Abstract
Aim. To study the dynamics of inspiratory pressure and volume in two versions of the experiment - mechanical pressure-controlled air-oxygen and helium-oxygen ventilation in the models of «healthy lung», «chronic obstructive pulmonary disease», «acute respiratory distress syndrome».
Methods. Inspiratory pressure and tidal volume were recorded during 10 respiratory cycles at each predetermined level from 5 to 20 cm H2O with a step of 5 cm H2O. TestСhest® was used as a model of the lungs which allows simulating normal function and some pathological states of the lungs sucj as COPD and ARDS.
Results. In the model of «healthy lung» inspiratory pressure in the application of air-oxygen mixture and helium-oxygen mixture was: at level 5 cm H2O - 6.4 (6.26; 6.50) and 7.17 (6.94; 7.17) cm H2O; 10 cm H2O - 11.31 (11.2; 11.43) and 12.11 (12.11; 12.27) cm H2O; 15 cm H2O - 16.8 (16.8; 17.03) and 15.24 (15.07; 15.24) cm H2O and at the level of 20 cm H2O - 18.83 (18.65; 19.04) and 21.52 (21.34; 21.67) cm H2O. At this, the respiratory volumes were 262.1 ml and 280.3 ml at the level 5 cm H2O; 541.8 ml and 577.9 ml at 10 cm H2O, 836.9 ml and 925.9 ml at 15 cm H2O; 1109 ml and 1265 ml at 20 cm H2O. In other studied models the inspiratory pressure and respiratory volume were also determined. Comparison of indicators revealed a statistically significant increase of the studied parameters in the simulated pathological conditions.
Conclusion. Pressure-controlled use of helium-oxygen mixture in the simulation of normal breathing mechanics, acute respiratory distress syndrome and chronic obstructive pulmonary disease is accompanied by a statistically significant increase in inspiratory pressure in the airways and inspiratory volume.
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##article.viewOnOriginalSite##About the authors
I N Grachev
S.M. Kirov Military Medical Academy
Author for correspondence.
Email: GrachewIN@mail.ru
Russian Federation, Saint Petersburg, Russia
B N Bogomolov
S.M. Kirov Military Medical Academy
Email: GrachewIN@mail.ru
Russian Federation, Saint Petersburg, Russia
A V Shchegolev
S.M. Kirov Military Medical Academy
Email: GrachewIN@mail.ru
Russian Federation, Saint Petersburg, Russia
E G Makarenko
S.M. Kirov Military Medical Academy
Email: GrachewIN@mail.ru
Russian Federation, Saint Petersburg, Russia
E N Ershov
S.M. Kirov Military Medical Academy
Email: GrachewIN@mail.ru
Russian Federation, Saint Petersburg, Russia
References
- Rodrigo G.J., Rodrigo C., Pollack C.V., Rowe B. Use of helium-oxygen mixtures in the treatment of acute asthma: a systematic review. Chest. 2003; 123: 891–896. doi: 10.1378/chest.123.3.891.
- Beurskens C.J.P., Wosten-van Asperen R.M., Preckel B., Juffermans N.P. The potential of heliox as a therapy for acute respiratory distress syndrome in adults and children: A descriptive review. Respiration. 2015; 89 (2): 166–174. doi: 10.1159/000369472.
- Berganza C.J., Zhang J.H. The role of helium gas in medicine. Med. Gas. Res. 2013; 3 (1): 18. doi: 10.1186/2045-9912-3-18.
- Austan F., Polise M. Management of respiratory failure with noninvasive positive pressure ventilation and heliox adjunct. Heart Lung. 2012; 31 (3): 214–218. doi: 10.1067/mhl.2002.123150.
- Tassaux D., Gainnier M., Battisti A., Jolliet P. Helium-oxygen decreases inspiratory effort and work of breathing during pressure support in intubated patients with chronic obstructive pulmonary disease. Int. Care Med. 2005; 31: 1501–1507. doi: 10.1007/s00134-005-2796-9.
- Ashworth L., Norisue Y., Koster M. et al. Management of pressure control ventilation: An algorithmic method of patient ventilatory management to address «Forgotten but Important Variables». J. Crit. Care. 2018; 43: 169–182. doi: 10.1016/j.jcrc.2017.08.046.
- Beurskens C.J., Aslami H., de Beer F.M. et al. Heliox allows for lower minute volume ventilation in an animal model of ventilator-induced lung injury. PLoS One. 2013; 8: e78159. doi: 10.1371/journal.pone.0078159.
- Yilmaz S., Daglioglu K., Yildizdas D. et al. The effectiveness of heliox in acute respiratory distress syndrome. Ann. Thorac. Med. 2013; 8 (1): 46–52. doi: 10.4103/1817-1737.105719.
- Beurskens C.J., Brevoord D., Lagrand W.K. et al. Heliox improves carbon dioxide removal during lung protective mechanical ventilation. Crit. Care Res. Pract. 2014; 954814: 5. doi: 10.1155/2014/954814.
- The R Project for Statistical Computing. https://www.R-project.org (access date: 21.02.2019).
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